College Statement Regarding Intravitreal Injections Administered by Non-Medical Practitioners in the Hospital Authority
香港眼科醫學院就醫院管理局試行由非醫生替病人進行眼內玻璃體腔內注射抗血管內皮生長因子手術之立場聲明

Dear Sir/Madam,
敬啟者：

In the light of the recent trial by the Hospital Authority to allow persons other than qualified physicians to perform the operations of intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) drugs on patients, the College of Ophthalmologists of Hong Kong expresses its serious concerns and issues the following statement:
香港眼科醫學院關注到醫院管理局在個別聯網試行由非醫生替病人進行眼內玻璃體腔內注射抗血管內皮生長因子手術。香港眼科醫學院對此安排深表關切，並作以下聲明：

Intravitreal injection is an invasive operation that carries risk of potentially serious complications, including but not limited to bacterial infections or endophthalmitis, intraocular hemorrhage, traumatic cataract, retinal detachment, and even blindness.
眼內玻璃體腔內注射抗血管內皮生長因子為入侵性手術，有嚴重潛在性風險，風險包括但不限於細菌感染或眼內炎、眼球內出血、創傷性白內障、視網膜脫落、以及失明等。

Only a few places in the world, such as Singapore and the United Kingdom, allow persons other than qualified physicians to perform this operation in their clinics and hospitals. Although these places profess that this operation would be performed under supervision and was the only way to cope with high volumes, this is clearly a sub-optimal solution. That is why, most developed countries in Europe, North America, Australasia, and Asia require intravitreal injections of anti-VEGF drugs to be performed by specialist doctors trained in these operations, or by qualified physicians undergoing specialist ophthalmological training and even then, under supervision. Furthermore, the drug’s package insert clearly states that this medication is to be administered only by a qualified physician. Therefore, the College of Ophthalmologists of Hong Kong has serious reservations about this trial arrangement.
世界上只有少數地方，例如星加坡或英國的醫院或診所，由一些已受一定訓練的非醫生，替病人進行此入侵性手術，其餘大部分歐美澳等先進國家均由眼科醫生進行眼內玻璃體腔內注射抗血管內皮生長因子手術。而藥物的説明書內亦詳細列明此藥物只可由醫生注射，因此香港眼科醫學院對醫院管理局此安排存有質疑並有嚴重保留。

We understand that the Hospital Authority has a large number of patients requiring intravitreal injections of anti-VEGF drugs, resulting in long waiting times for the operations. However, there are many other effective and safe ways to shorten the waiting time, such as public-private partnerships, collaborations with non-governmental organizations, and Hospital Authority’s own Special Honorarium Scheme (SHS). We believe that intravitreal injections of anti-VEGF drugs by qualified physicians is the safest option. Hong Kong has sufficient numbers of qualified physicians and does not need to adopt the sub-optimal solution now undertaken by the Hospital Authority.
香港眼科醫學院理解醫院管理局病人眾多，輪候進行眼內玻璃體腔內抗血管內皮生長因子注射手術時間長。但其實縮短輪候時間有很多其他有效及安全的方法，包括公私營醫療合作 (Public Private Partnership)、與非政府機構 (Non-Government Organization) 合作、及特別酬金計劃 (Special Honorarium Scheme) 等。而情況允許下，由醫生替病人進行眼內玻璃體腔內抗血管內皮生長因子注射手術為最安全選擇。

The College of Ophthalmologists of Hong Kong will continue to work with the Hospital Authority to explore viable and safe options to shorten the waiting time, while striking an appropriate balance between timely treatment and patient safety, always bearing in mind that the interest of the patient is of paramount importance.
因此，香港眼科醫學院會繼續和醫院管理局合作，儘量嘗試尋求其他方法去縮短輪候時間，在病人安全及輪候時間中取適當平衡。無論如何，以病人健康利益為依歸。

The College of Ophthalmologists of Hong Kong
香港眼科醫學院

2023.08.22